First appropriate implantable defibrillator shocks in patients with Chagasic heart disease

Abstract

Objectives:The objectives of the study were to assess if patients with Chagas heart disease (CHD) received appropriate automatic implantable defibrillator (AID) shocks earlier than patients with ischemic heart disease (IHD). Methods: Analysis of a retrospective cohort of patients with CHD and IHD who received an implantable cardioverter defibrillator (ICD) between 2009 and 2018, in a tertiary hospital. We evaluated the time between the implant of ICD and the first appropriate shock in patients with CHD and compared it with the IHD control population. Results: we included a total of 64 patients, 20 with CHD and 44 with IHD. CHD patients presented earlier an appropriate shock than patients with IHD during the 1 st year (hazard ratio [HR]: 8.4; 95% confidence interval [95%CI]: 2.09-34.02; p = 0.0027), and at 3 years (HR: 4.61; p = 0.0072). About 100% of CHD patients who received the ICD as secondary prevention of sudden cardiac death presented an appropriate shock during the first 26 months of follow-up. Conclusions: Patients with CHD received appropriate ICD shocks earlier than the IHD patients. All patients with CHD and ICD as secondary prevention had an appropriate ICD shock at short term, representing the highest risk population, and supporting the indication of the device in a setting where randomized clinical trials are lacking.